Contraception and cancer

The News Story - Why you’re still paying for birth control even though it’s “free” now

Susie Poppick writes for TIME this week about her near-miss at having to fork over a $50 copay for her birth control.

“Strange,” she thought, since she was sure that “preventative” health services like contraception were supposed to be free under the Affordable Care Act. She promptly went home, got on the phone with her insurance provider, and was told that only generic medications were free. The problem is, her particular brand didn’t have a generic yet. She dug a little deeper, and she was quickly told that all she had to do was to tell her physician to call her pharmacy and assure them that she needed this brand.

Poppick cautions women against being taken in, and writes that “Many women—and their insurance representatives, doctors, and pharmacists—aren’t on the same page about whether their particular contraception should have a copay or not.” The best thing for women to do is to educate themselves, and soon, such obstacles will be taken care of.

But recent research suggests that journalists like Ms. Poppick should spend less time on getting free birth control and more time on educating themselves and others on the deadly risks posed by hormonal contraception.

The New Research - Prescribing brain cancer

Feminists consistently urge legislators to continue making access to contraception universal and free. The more women on the pill, the better “liberated” we all are. But a new study out of Denmark should make policymakers pause before jumping on the “free birth control for all” bandwagon.

In a paper accepted by the British Journal of Pharmacology, researchers Lene Andersen et al. study the effect of oral contraceptive use on the risk of developing glioma, a type of cancerous brain tumor. The researchers establish the background for their study by pointing out that use of hormonal contraceptives “slightly increases” the risk of several types of cancer, including cervical cancer, breast cancer, and hepatocellular carcinoma. In spite of this increased risk, however, “few studies have examined any link with risk of central nervous system tumors.” Previous studies focusing on the link between glioma and oral contraceptive use have shown little association, but the use of such findings is limited because the subjects were postmenopausal women.

The researchers obtained their data from a host of national registries tracking Danish cancer patients. They reduced their sample to women between the ages of 15 and 49 “with a histologically verified first diagnosis of brain glioma during 2000-2009.” Subjects had no previous instance of cancer. “Ever use” of oral contraceptives was defined as women who had taken two prescriptions or more, while “non-use” was defined as fewer than two prescriptions. For IUDs, “ever use” was one prescription. The researchers also defined “recent use” as one prescription or less taken in the past 2-5 years. Type (combined estrogen-progestagen, progestagen-only, or mixed use) was also considered.

In the end, the sample “consisted of 317 cases and 2,126 controls, which were similar for distribution of age, parity, and years of schooling.” The findings? “Long-term use of hormonal contraceptives was associated with an increased risk of glioma that increased with duration of use.” In their study, almost 60% of the sample and 50% of the controls had ever used hormonal contraceptives. The risk of developing glioma was higher for current or recent use (Odds Ratio of 1.7; 95% Confidence Interval: 1.3-2.4). Moreover, “the OR for glioma was elevated with use of combined estrogen and progestagen (OR, 1.4; 95% CI: 1.0-1.8) and highest for pregestagen-only (OR, 2.8; 95% CI: 1.6-5.1).”

Given “the extensive use of hormonal contraceptives,” the researchers close, “our finding merits further investigation.”

Indeed. In a world in which hormonal contraceptives are often prescribed to girls as soon as they reach menarche, studies such as these should cause policymakers to say “hold on” before cheerfully handing out more free pills.

Nicole M. King is the managing editor of The Howard Center’s quarterly journal, The Family in America: A Journal of Public Policy, the United States’ leading journal of family-policy research. In that capacity, she writes, edits, and corresponds with editors and contributors to ensure that each issue provides the most relevant and accurate research and policy analysis available.